Provider Demographics
NPI:1780894915
Name:GARCIA, MICHELLE FISHER (PT)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:FISHER
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:LEILANI PATRICE
Other - Last Name:FISHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3416 POLO CLUB LN SE
Mailing Address - Street 2:B201
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-5166
Mailing Address - Country:US
Mailing Address - Phone:808-256-8763
Mailing Address - Fax:
Practice Address - Street 1:4528 INTELCO LOOP SE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-5916
Practice Address - Country:US
Practice Address - Phone:360-491-1141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist